U.S. patent number 6,167,412 [Application Number 09/115,457] was granted by the patent office on 2000-12-26 for handheld medical calculator and medical reference device.
This patent grant is currently assigned to Agilent Technologies, Inc.. Invention is credited to Tad Decatur Simons.
United States Patent |
6,167,412 |
Simons |
December 26, 2000 |
Handheld medical calculator and medical reference device
Abstract
A handheld medical calculator and reference device having an
input keypad and an output screen connected to a processor with
memory to perform specific clinical functions. The clinical
functions include: basic mathematical operations and common
scientific functions for routine calculations; store/recall
functions for numbers and for routinely used program settings;
phone directory; user selection of display modes (fixed,
scientific, choice of radix), degree/radian; time, date, and day of
week features for timing and alarms (with display format choices);
drug and infusion calculations; hemodynamic and cardiac functions;
respiratory and pulmonary functions; acid-base functions;
nutritional functions; nomograms, maps, and a reference table of
normal values; and patient vital signs record keeping.
Inventors: |
Simons; Tad Decatur (Palo Alto,
CA) |
Assignee: |
Agilent Technologies, Inc.
(Palo Alto, CA)
|
Family
ID: |
22361536 |
Appl.
No.: |
09/115,457 |
Filed: |
July 14, 1998 |
Current U.S.
Class: |
708/105;
600/300 |
Current CPC
Class: |
G06F
15/025 (20130101); G16H 20/10 (20180101); G16H
70/40 (20180101); G16H 70/60 (20180101); G16H
40/63 (20180101) |
Current International
Class: |
G06F
15/02 (20060101); G06F 019/00 () |
Field of
Search: |
;708/105,132,200
;600/300,481,508,529 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Apothecalc(TM) [Advertisement], NNCC, Inc., 100 Precision Court,
Lancaster, KY 40444, p. 1. .
PEPID [Advertisement], PEPID, Inc., Greenwood St., Evanston, IL
60201-4712, pp. 1-4. .
Pocket PDR(TM) [Advertisement], Physician's Desk Reference, P.O.
Box 824, Mahwah, NJ 07430, pp. 1-2. .
Computer Books Medical Software [Advertisement], ComputerBooks,
Newport Trade Centre, 20321 Irvine Avenue, Suite 2, P.O. Box 9167,
Newport Beach, CA 92658-9986, pp. 1-2..
|
Primary Examiner: Malzahn; David H.
Claims
What is claimed is:
1. A handheld medical device, comprising:
an output mechanism for outputting a plurality of preconfigured
prompts and a medical answer;
an input mechanism operatively associated with said output
mechanism, said input mechanism for inputting a predetermined
medical question, information, and choices among plurality of said
preconfigured prompts;
memory operatively connected to said input and output mechanisms,
said memory containing said plurality of preconfigured prompts for
said predetermined medical question and said medical answer;
and
a processor connected to said memory and said input and output
mechanisms, said processor:
responsive to said predetermined medical question input at said
input mechanism to cause said memory to provide said preconfigured
prompts to said output mechanism,
responsive to said preconfigured prompts to receive said
information and said choices among said plurality of preconfigured
prompts from said input mechanism,
responsive to said choices among said plurality of preconfigured
prompts to process said medical answer, and
operable with said memory as a result of said predetermined medical
question, said information, and said choices among said plurality
of preconfigured prompts to provide said medical answer to said
output mechanism.
2. The handheld medical device as claimed in claim 1 wherein:
said output mechanism is capable of outputting a plurality of
preconfigured prompts and a plurality of information adjacent to
and related to said plurality of preconfigured prompts, said output
mechanism is capable of outputting at least one preconfigured
prompt related to said predetermined medical question;
said input mechanism is capable of being operatively associated
with said output mechanism and said at least one preconfigured
prompt; and
said processor is operable to establish the operative association
of said input mechanism with said at least one preconfigured prompt
from said output mechanism.
3. The handheld medical device as claimed in claim 1 wherein:
said output mechanism is a display capable of displaying a
plurality of preconfigured prompts and a plurality of information
adjacent to and related to said plurality of preconfigured prompts,
and said display is capable of simultaneously displaying all of
said preconfigured prompts and input information related to said
predetermined medical question.
4. The handheld medical device as claimed in claim 1 wherein:
said memory contains drug dosage information;
said processor includes a calculator;
said processor is responsive to said input mechanism inputting a
drug question to provide said preconfigured prompt to obtain
patient information;
said processor is responsive to said input mechanism inputting
patient information to use said patient information and said drug
information from said memory to calculate a drug dosage answer;
and
said processor is operable to cause said output mechanism to output
said drug dosage answer.
5. The handheld medical device as claimed in claim 1 wherein:
said memory contains respiratory and pulmonary information;
said processor includes a calculator;
said processor is responsive to said input mechanism inputting a
respiratory or pulmonary question to provide said preconfigured
prompt to obtain prescription and patient information;
said processor is responsive to said input mechanism inputting
prescription and patient information to use said prescription and
patient information and said respiratory and pulmon ary information
from said memory to respectively calculate a respiratory or
pulmonary answer; and
said processor is operable to cause said output mechanism to output
said respiratory or pulmonary answer.
6. The handheld medical device as claimed in claim 1 wherein:
said memory contains acid-base information and an acid-base
nomogram;
said processor includes a calculator;
said processor is responsive to said input mechanism inputting an
acid-base question to use said acid-base information and said
acid-base nomogram from said memory to calculate an acid-base
answer; and
said processor is operable to cause said output mechanism to output
said acid-base answer.
7. The handheld medical device as claimed in claim 1 wherein:
said memory contains a medicai mapping and a medical nomogram;
said output mechanism is a display capable of displaying said
medical mapping and said medica nomogram;
said processor is responsive to said input mechanism inputting a
medical mapping question or medical nomogram question to cause said
output mechanism to respectively display said medical mapping, or
said medical nomogram.
8. The handheld medical device as claimed in claim 1 wherein:
said memory contains information on normal values for various human
conditions; and
said processor is responsive to said input mechanism inputting a
question on a normal human condition to use said information from
said memory to provide said normal value and to cause said output
mechanism to output said normal value as an answer.
9. The handheld medical device as claimed in claim 1 wherein:
said memory contains cardiac and hemodynamic information;
said processor includes a calculator;
said processor is responsive to said input mechanism inputting a
cardiac or hemodynamic question to use said cardiac and hemodynamic
information from said memory to respectively calculate a cardiac or
hemodynamic answer; and
said processor is operable to cause said output mechanism to output
said cardiac or hemodynamic answer.
10. The handheld medical device as claimed in claim 1 wherein:
said memory contains nutrition information;
said processor includes a calculator;
said processor is responsive to said input mechanism inputting a
nutrition question to provide said preconfigured prompt to obtain
patient information;
said processor is responsive to said input mechanism inputting
patient information to use said patient information and said
nutrition information from said memory to respectively calculate a
nutrition answer; and
said processor is operable to cause said output mechanism to output
said nutrition answer.
11. The handheld medical device as claimed in claim 1 wherein:
said input information is patient information;
said memory is capable of storing said patient information; and
said processor is responsive to said input mechanism inputting said
predetermined medical question to cause said output mechanism to
output said patient information.
12. A handheld medical calculator and reference device,
comprising:
a display for outputting first and second preconfigured prompts and
a medical answer;
a keypad operatively associated with said display, said keypad for
inputting a predetermined medical question, information, and
choices among said first and second preconfigured prompts;
a memory operatively connected to said keypad and display, said
memory containing said first and second preconfigured prompts for
said predetermined medical question and medical data; and
a processor connected to said memory and said keypad and said
display, said processor:
responsive to said predetermined medical question input at said
keypad to cause said memory to provide said first preconfigured
prompts to said display,
responsive to said information at said keypad to provide said
second preconfigured prompts,
responsive to said information and said choices among said second
preconfigured prompts to process said information and said
plurality of preconfigured responses with said medical data in said
memory to produce said medical answer, and
operable to provide said medical answer to said display.
13. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said display is capable of displaying a plurality of second
preconfigured prompts and a plurality of information adjacent to
and related to said plurality of second preconfigured prompts, said
display is capable of displaying at least one first preconfigured
prompt related to said predetermined medical question;
said keypad has at least one key capable of being operatively
associated with said display and said at least one first
preconfigured prompt; and
said processor is operable to establish the operative association
of said at least one key with said at least one first preconfigured
prompt on said display.
14. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said display is capable of displaying a plurality of second
preconfigured prompts and a plurality of information adjacent to
and related to said plurality of second preconfigured prompts, and
said display is capable of simultaneously displaying all of said
second preconfigured prompts and all of said input information
related to said predetermined medical question.
15. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains drug dosage information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a drug
question to provide preconfigured prompts for prescription, patient
weight, renal insufficiency, and drug concentration
information;
said processor is responsive to said keypad inputting said
prescription, patient weight, renal insufficiency, and drug
concentration information to use said information and said drug
dosage information from said memory to calculate a drug dosage
answer with adjustment for body surface area and weight; and
said processor is operable to cause said display to output said
drug dosage answer.
16. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains drug infusion information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a drug
infusion question to provide preconfigured prompts for
prescription, patient weight, renal insufficiency, and drug
concentration information;
said processor is responsive to said keypad inputting said
prescription, patient weight, renal insufficiency, and drug
concentration information to use said information and said drug
infusion information from said memory to calculate a drug infusion
answer with adjustment for body surface area and weight; and
said processor is operable to cause said display to output said
drug infusion answer.
17. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains respiratory and pulmonary nomograms and
information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a respiratory
or pulmonary question to provide said second preconfigured prompts
to ask ventilation parameters questions;
said processor is responsive to said keypad inputting said
ventilation parameters question to provide further preconfigured
prompts for relevant patient data;
said processor is responsive to say keypad inputting said relevant
patient data to use said nomogram to determine body surface area
and respiration rate;
said processor is responsive to say keypad inputting said relevant
patient data to calculate minute ventilation and tidal volume;
and
said processor is operable to cause said display to output said
minute ventilation, tidal volume, and respiration rate.
18. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains respiratory and pulmonary mapping and
information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a respiratory
or pulmonary question to provide said second preconfigured prompts
to ask a vital capacity question;
said processor is responsive to said keypad inputting said vital
capacity question to provide further preconfigured prompts for
relevant patient data;
said processor is responsive to say keypad inputting said relevant
patient data to calculate said vital capacity; and
said processor is operable to cause said display to output said
vital capacity and mapping.
19. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains acid-base information and an acid-base
nomogram;
said processor includes a calculator;
said processor is responsive to said keypad inputting an acid-base
question to cause said display to output said second preconfigured
prompts on acid-base equations, acid-base disorders, and other
acid-base related quantities;
said processor is responsive to keypad input of said acid-base
equations, acid-base disorders, and other acid-base related
quantities and said acid-base information and said acid-base
nomogram from said memory to determine acid-base solutions, list
acid-base disorders, and calculated acid-base related quantities;
and
said processor is operable to cause said display to output
acid-base solutions, list acid-base disorders, and calculated
acid-base related quantities.
20. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains medical information and a medical
nomogram;
said processor includes a calculator;
said processor is responsive to said keypad inputting a medical
question to use said medical information and said medical nomogram
from said memory to provide a recommended treatment; and
said processor is operable to cause said display to output said
recommended treatment.
21. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains cardiac information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a cardiac
question to provide said second preconfigured prompts for cardiac
function tests, cardiac work indices, and vascular resistance;
said processor is responsive to said keypad inputting said cardiac
function tests, cardiac work indices, and vascular resistance to
provide further preconfigured prompts for patient information;
said processor is responsive to said patient information to
calculate said cardiac function tests, cardiac work indices, and
vascular resistance; and
said processor is operable to cause said display to output said
cardiac function tests, cardiac work indices, and vascular
resistance.
22. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains hemodynamic information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a hemodynamic
question to provide said second preconfigured prompts for patient
information, pressure data, or heart data;
said processor is responsive to said keypad inputting said patient
information, pressure data, or heart data to indicate missing
information or data;
said processor is responsive to said missing information or data to
calculate said missing information or data; and
said processor is operable to cause said display to output
completed patient information, pressure data, or heart data.
23. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said memory contains nutritional information;
said processor includes a calculator;
said processor is responsive to said keypad inputting a nutritional
question to provide said second preconfigured prompts for
metabolic, assessment, and hyperalimentation determinations;
said processor is responsive to said keypad inputting said for
metabolic, assessment, and hyperalimentation determinations to
calculate basal metabolic rate, basal energy expenditure, nitrogen
balance, BUN/urea conversion, lean body mass, ideal body weight, or
time, concentrations, and flow rate for nutrients; and
said processor is operable to cause said display to output said
basal metabolic rate, basal energy expenditure, nitrogen balance,
BUN/urea conversion, lean body mass, ideal body weight, or time,
concentrations, and flow rate for nutrients.
24. The handheld medical calculator and reference device as claimed
in claim 12 wherein:
said processor is responsive to the input of patient data to store
such patient data in said memory; and
said processor is responsive to said keypad inputting a patient
question to retrieve said patient data from said memory and cause
said display to output said patient data.
Description
TECHNICAL FIELD
The present invention relates generally to medical computers and
more specifically to a handheld medical calculator and medical
reference device for health care professionals.
BACKGROUND ART
Nurses, intensive care personnel, respiratory therapists, emergency
room staff, paramedics, chemists, and other clinicians have certain
things that they do all the time which must be done properly
otherwise there may be serious consequences up to and including the
death of a patient.
An example relates to drug and infusion calculations. A doctor
issues prescriptions to clinicians based on the body weight of the
patient since different size people take different amounts of
drugs. A clinician must then get the drug from the pharmacy which
provides it at a standard concentration and, looking at the order
from a doctor and patient information on body weight, calculate
precisely how much medication to give over a certain period of
time. Sometimes, the dosages are based on body surface area and
require further calculations and constants.
The calculations are often complex and require specific constants
for dosages and infusions. Very experienced clinicians who have
long experience will have memorized the constants, but newer
clinicians or those who do not routinely work in the area will have
to lookup the constants in a reference book in addition to
performing the complex calculations. Thus, in addition to handheld
calculators, these people usually must carry around little
reference booklets which must fit the pockets in their lab
coats.
In some cases where the prescriptions are routine, the clinicians
will be provided with small charts to look up how much medication
to give for a given body weight. However, even this is of limited
value since many drugs are provided in solution at a specific
concentration per volume of fluid, or a specific mass per tablet. A
clinician must then compute the correct total dose for a patient.
These calculations must often be performed with dimensioned units
which must be converted into other comparable units in order to
perform the calculations. For example, the prescription could be in
terms of so many micrograms per square meter of body surface, while
the drug concentration could be in milligrams per cubic centimeter.
A mistake in the decimal point could kill a patient.
For some areas of medicine, a clinician will be told by a doctor to
obtain certain medical data about a patient which are calculated
from other parameters. These calculations are complex and often
difficult to perform. An easy method to calculate these important
parameters would benefit patient treatment. Cardiac, hemodynamic,
respiratory and ventilatory calculations often fall into this
category.
Another example is if a patient has been poisoned, and it is
necessary to determine how long it takes for the toxins to wear off
and how the patient is responding to treatment. There are complex
relationships involved for which various nomograms have been
developed for various toxins where observations are required over a
timeframe.
Acid-base disorders also require complex calculations with several
independent variables. These calculations in turn are often
difficult to use and introduce mistakes into the treatment
process.
For all health care professionals, handy drug references have long
been desirable, but a comprehensive reference has had to be
extremely bulky because of all the information and cross-references
required. Computerized references have also been more convenient in
laptop form, but the cross-referencing systems have made them
difficult to use. Also, computers are not always available for
clinicians. It is often not convenient to use laptop computers in a
clinical setting, and they are relatively costly when compared to
the cost of handheld calculators.
In the medical field, it is further necessary to have readily
available the many different values of what constitutes the norm of
the human physiology to determine how far off a patient is from
normal. These values must be constantly referred to such that the
small reference books regularly fall apart, become hard to read,
and must be constantly replaced. Thus, a hand size reference has
long been sought which provides easy accessibility and
convenience.
A comprehensive solution for clinicians has long been sought which
would ease their workload, simplify the complexity of the things
they do, and reduce the life threatening errors, but such a
solution has long eluded those skilled in the art.
DISCLOSURE OF THE INVENTION
The principal purpose of this device is to relieve the tedious and
repetitive calculations and reference searches routinely performed
by clinical staff. To achieve this purpose, the device is simple
and inexpensive. There are many unused (shifted) keys that lend
themselves to new functions and applications, but the device is
kept simple. The medical users are often harried and tired, and a
complicated design would diminish the utility of this device in a
hospital or clinical setting. The device follows the style of
specialized calculators, such as the scientific, business, and
engineering calculators. The device is for clinicians and has the
following functions in a format of selecting functions and
receiving unambiguous, preconfigured prompts:
1. Basic mathematical operations and common scientific functions
for routine calculations.
2. Store/Recall functions for numbers, and for routinely used
program settings and a phone directory.
3. User selection of display modes (fixed, scientific, choice of
radix), degree/radian, etc.
4. Time, date, day of week, and features for timing and alarms.
5. Drug and infusion calculations
6. Hemodynamic and cardiac functions.
7. Respiratory and pulmonary functions.
8. Acid-base functions.
9. Nutritional functions.
10. Common nomograms, and a reference table of normal values.
11. Patient vital signs record keeping.
The present invention has the advantage of being programmed with
straightforward, preconfigured prompts of predetermined medical
questions so the clinician does not have to do any programming or
customizations.
The present invention has the additional advantage of having a
softkey display for preconfigured prompts and related softkeys for
simplified input of medical questions and information. Softkeys are
so designated because they are keys programmed for different
functions by internal software. While most of the input keys of the
present invention have two functions based on their shifted or
unshifted modes of operation, the softkeys have a plurality of
functions based on the preconfigured prompts which appear as text
on associated display areas.
The present invention has the additional advantage of providing a
handheld device for performing complex drug calculations in a
simple, straightforward manner.
The present invention has the additional advantage of providing a
handheld device for performing complex drug and medical-related
calculations in a simple, straightforward manner.
The present invention has the additional advantage of providing a
handheld device for performing complex cardiac calculations in a
simple, straightforward manner.
The present invention has the additional advantage of providing a
handheld device for performing acid-base respiratory and
nutritional calculations in a simple, straightforward manner.
The present invention has the additional advantage of providing a
handheld device for providing complex medical reference information
in a simple, straightforward manner.
The above and additional advantages of the present invention will
become apparent to those skilled in the art from a reading of the
following detailed description when taken in conjunction with the
accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an embodiment of the present invention;
FIG. 2 is the portion of the embodiment used for the basic
mathematical calculator functions;
FIG. 3 is the portion of the device used for the time and medical
time functions;
FIG. 4, is the bottom of the screen of the device resulting from
one selection of the keys used for the time and medical time
functions;
FIG. 5, is the screen resulting from another selection of the keys
used for the time and medical time functions;
FIG. 6 is the screen resulting from another selection of the keys
used for the time and medical time functions;
FIG. 7 is the screen resulting from another selection of the keys
used for the time and medical time functions;
FIG. 8 is the screen resulting from another selection of the keys
used for the time and medical time;
FIG. 9 is the portion of the device used for the drug and infusion
calculation functions;
FIG. 10 is the screen resulting from another selection of the keys
used for the drug and infusion calculation functions;
FIG. 11 is the screen resulting from another selection of the keys
used for the drug and infusion calculation functions;
FIG. 12 is the screen resulting from another selection of the keys
used for the drug and infusion calculation functions;
FIG. 13 is the screen resulting from another selection of the keys
used for the drug and infusion calculation functions;
FIG. 14 is the screen resulting from another selection of the keys
used for the drug and infusion calculation functions;
FIG. 15 is the portion of the device used for the cardiac function
calculations;
FIG. 16 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 17 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 18 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 19 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 20 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 21 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 22 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 23 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 24 is the screen resulting from another selection of the keys
used for the cardiac function calculations;
FIG. 25 is the portion of the device used for the respiratory
calculations;
FIG. 26 is the screen resulting from another selection of the keys
used for the respiratory calculations;
FIG. 27 is the screen resulting from another selection of the keys
used for the respiratory calculations;
FIG. 28 is the screen resulting from another selection of the keys
used for the respiratory calculations;
FIG. 29 is the screen resulting from another selection of the keys
used for the respiratory calculations;
FIG. 30 is the portion of the device used for the acid-base
calculations;
FIG. 31 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 32 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 33 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 34 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 35 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 36 is the screen resulting from another selection of the keys
1 used for the acid-base calculations;
FIG. 37 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 38 is a screen which shows a map which could result from
another selection of the keys used for the acid-base
calculations;
FIG. 39 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 40 is the screen resulting from another selection of the keys
used for the acid-base calculations;
FIG. 41 is the portion of the device used for the nutritional
functions;
FIG. 42 is the portion of the device used for the patient logging
and telephone numbers functions;
FIG. 43 is the screen resulting from another selection of the keys
used for the patient logging;
FIG. 44 is the portion of the device used for accessing the medical
references which include tables of normal values and common
nomograms;
FIG. 45 is the portion of the device used for controlling the
calculator modes functions;
FIG. 46 is the portion of the device used for controlling the
display format on the screen;
FIG. 47 is the portion of the device used for clearing selected
parts of the screen;
FIG. 48 is the screen resulting from another selection of the keys
used for obtaining a list of patients; and
FIG. 49 is a simplified block diagram of the device.
BEST MODE FOR CARRYING OUT THE INVENTION
Referring now to FIG. 1, therein is shown the handheld medical
calculator and medical reference device, referred to as the device
10. The device 10 has a high resolution, multi-character, output
screen 12 and input keypad 14. It should be noted that the specific
types and locations of the screen 12 and keypad 14 are optional
with various types of lower resolution and ultrahigh resolution
displays being useable as well as touch-sensitive displays and
membrane keypads.
The screen 12 has a plurality of display lines 16, 18, 20, 22, and
24, and a softkey display line 26. The softkey display line 26 has
six softkey title areas 28, 30, 32, 34, 36, and 38. These softkey
title areas are where various preconfigured prompts appear, as will
later be described. The prompts are preconfigured in that they are
designed to make the device 10 operate intuitively and are not
intended to be changed by the user.
The keypad 14 has a line of keys identified as softkeys 40, 42, 44,
46, 48, and 50 which are respectively below and which relate
respectively to the softkey title areas 28, 30, 32, 34, 36, and 38.
When there is a display on the softkey title areas 28, 30, 32, 34,
36, and 38, their respective softkeys 40, 42, 44, 46, 48, and 50
will be active in their sofikey modes.
The softkeys also have other functions where they do not function
as softkeys and there are no displays in the softkey title areas
although dedicated sofikeys would simplify the device 10. Dedicated
softkeys would not have other functions. They would be dedicated
for use only with the softkey title areas or for use in the
unshifted mode. In the unshifted mode, their functions would be for
the most popular series of calculations for which the device 10 is
likely to be used.
Below, the softkeys are described in their non-softkey modes. The
unshifted key functions and shifted key functions will first be
described and then explained later.
The softkey 40 has a UNIT function and in the shifted position a
CONV function. The softkey 42 has a DRUG function and, in the
shifted position, a INFUSE function. The softkey 44 has an ACID
BASE function and, in the shifted position, a NUTR function. The
softkey 46 has a 1/x function and, in the shifted position, a
10.sup.x function. The softkey 48 has a y.sup.x function and, in
the shifted position a LOG function. The softkey 50 has a e.sup.x
function and, in the shifted position, a LN function.
A first row of function keys 52, 54, 56, 58, 60, and 62 is below
the softkeys. The function key 52 has a STO function and, in the
shifted position, an opening for a function. The function key 54
has a RCL function and, in the shifted position, an opening for a
function. The function key 56 has a CARD function and, in the
shifted position, a RESP function. The function key 58 has a SIN
function and, in the shifted position, an ASIN function. The
function key 60 has a COS function and, in the shifted position, an
ACOS function. The function key 62 has a TAN function and, in the
shifted position, an ATAN function.
A row of second function keys 64, 66, 68, 70, and 72 is below the
first row of function keys. The function key 64 has an ENTER/=
function and, in the shifted position, an ALPHA function. The
function key 66 has a x.rarw..fwdarw.y function and, in the shifted
position, a TIME function. The function key 68 has a +/- function
and, in the shifted position, a MODES function. The function key 70
has an E function and, in the shifted position, a DISP function.
The function key 72 has a .rarw. function and, in the shifted
position, a CLEAR function.
A first row of calculation keys 74, 76, 78, 80, and 82 is below the
second row of function keys. The calculation key 74 has a
.tangle-solidup. which is an up scroll function and, in the shifted
position a COMPLEX function. The calculation key 76 has a 7 which
is a numerical entry function and, in the shifted position, an
opening for a function. The calculation key 78 has a 8 which is a
numerical entry function and, in the shifted position, a x.sup.2
function. The calculation key 80 has a 9 which is a numerical entry
function and, in the shifted position, an .sqroot. which is a
square root function. The calculation key 82 has a .div. which is a
divide function and, in the shifted position, a .pi. function.
A second row of calculation keys 84, 86, 88, 90, and 92 is below
the first row of calculation keys. The calculation key 84 has a
.tangle-soliddn. which is a down scroll function and, in the
shifted position a MATRIX function. The calculation key 86 has a 4
which is a numerical entry function and, in the shifted position,
an opening for a function. The calculation key 88 has a 5 which is
a numerical entry function and, in the shifted position, an opening
for a function. The calculation key 90 has a 6 which is a numerical
entry function and, in the shifted position, an an opening for a
function. The calculation key 92 has an X which is a multiply
function and, in the shifted position, a % function.
A third row of calculation keys 94, 96, 98, 100, and 102 is below
the second row of calculation keys. The calculation key 94 has a
.box-solid. which is the shift key for selecting in the unshifted
position the functions labeled on the keys or for selecting in the
shifted position the functions labled over the keys. The
calculation key 96 has a 1 which is a numerical entry function and,
in the shifted position, an opening for a function. The calculation
key 98 has a 2 which is a numerical entry function and, in the
shifted position, an opening for a function. The calculation key
100 has a 2 which is a numerical entry function and, in the shifted
position, an opening for a function. The calculation key 102 has an
- which is a subtract function and, in the shifted position, a)
close parenthesis function.
A bottom row of keys 104, 106, 108, 110, and 112 is below the third
row of calculation keys. The key 104 has a EXIT function and it is
also the ON and OFF function key. The key 106 has a 0 which is a
numerical entry function and, in the shifted position, a NOMO
function for accessing various nomograms. The key 108 has a . which
is the decimal point entry function and, in the shifted position, a
NORM function to provide information on normal values. The key 110
has a PT patient function and, in the shifted position, a telephone
function. The key 112 has an + which is an add function and, in the
shifted position, a (open parenthesis function. Internally (and
thus not shown), is a simple processing unit and electronic memory.
The memory is loaded with dedicated medical software for the
processing unit and with medical reference material.
Referring now to FIG. 2, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the basic mathematical
calculator functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 3, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the time and medical time
functions numbered with the same numbers as in FIG. 1.
Referring now to FIG. 4, therein is shown the bottom of screen 12
resulting from one selection of the keypad 14 used for the time and
medical time functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 5, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the time and
medical time functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 6, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the time and
medical time functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 7, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the time and
medical time functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 8, therein is shown the screen 12 resulting
from one selection of the keypad 14 used for the time and medical
time functions numbered with the same numbers as in FIG. 1.
Referring now to FIG. 9, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the drug and infusion
calculation functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 10, therein is shown the screen 12 resulting
from one selection of the keypad 14 used for the drug and infusion
calculation functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 1, therein is shown the screen 12 resulting
from one selection of the keypad 14 used for the drug and infusion
calculation functions numbered with the same numbers as in FIG.
1.
Referring now to FIG. 12, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the drug and
infusion calculation functions numbered with the same numbers as in
FIG. 1.
Referring now to FIG. 13, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the drug and
infusion calculation functions numbered with the same numbers as in
FIG. 1.
Referring now to FIG. 14, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the drug and
infusion calculation functions numbered with the same numbers as in
FIG. 1.
Referring now to FIG. 15, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the cardiac function
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 16, therein is shown the screen 12 resulting
from one selection of the keypad 14 used for the cardiac function
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 17, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 18, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 19, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 20, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 21, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 22, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 23, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 24, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the cardiac
function calculations numbered with the same numbers as in FIG.
1.
Referring now to FIG. 25, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the respiratory calculations
numbered with the same numbers as in FIG. 1.
Referring now to FIG. 26, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the respiratory
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 27, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the respiratory
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 28, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the respiratory
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 29, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the respiratory
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 30, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the acid-base calculations
numbered with the same numbers as in FIG. 1.
Referring now to FIG. 31, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 32, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 33, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 34, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 35, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 36, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 37, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 38, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1. This
screen 12 shows a map of acid-base conditions from which the device
10 outputs specific information on the state of a patient and gives
corrective instructions which is possible with a high resolution
screen.
Referring now to FIG. 39, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 40, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the acid-base
calculations numbered with the same numbers as in FIG. 1.
Referring now to FIG. 41, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the nutritional functions
numbered with the same numbers as in FIG. 1.
Referring now to FIG. 42, therein is shown the device 10 with the
screen 12 and the keypad 14 used for the patient logging flnctions
numbered with the same numbers as in FIG. 1.
Referring now to FIG. 43, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for the patient
logging and telephone numbers functions numbered with the same
numbers as in FIG. 1.
Referring now to FIG. 44, therein is shown the device 10 with the
screen 12 and the keypad 14 used for accessing the medical
references numbered with the same numbers as in FIG. 1. The medical
references include tables of normal values and common
nomograms.
Referring now to FIG. 45, therein is shown the device 10 with the
screen 12 and the keypad 14 used for controlling the modes
functions numbered with the same numbers as in FIG. 1.
Referring now to FIG. 46, therein is shown the device 10 with the
screen 12 and the keypad 14 used for controlling the display format
on the screen 12 numbered with the same numbers as in FIG. 1.
Referring now to FIG. 47, therein is shown the device 10 with the
screen 12 and the keypad 14 used for clearing selected parts of the
screen 12 numbered with the same numbers as in FIG. 1.
Referring now to FIG. 48, therein is shown the screen 12 resulting
from another selection of the keypad 14 used for obtaining a list
of patients numbered with the same numbers as in FIG. 1.
Referring now to FIG. 49, therein is shown a simplified block
diagram of the device 10 which includes the keypad 14, a processor
120, and a memory 122.
The operation of the device 10 is as follows.
Basic Mathematical Calculator
The mathematical section of the keyboard shown of FIG. 1 is similar
to that of other mathematical calculators. The shift key
.box-solid. 94 gives choices above the selected key.
1. There is a conventional 10-key numerical pad for add, subtract,
multiply, and divide functions.
2. Open and closed parentheses (.box-solid.+ and .box-solid.-) keys
102 and 112 shifted give option of using the calculator in
algebraic mode (e.g., 1+2=3), or in Reverse Polish Notation (RPN,
e.g., 1, ENTER, 2, +) in the manner of most HP calculators. For
doctors, nurses, and other health care workers, RPN may not be the
first choice. Most may prefer conventional algebraic notation. The
keys function as follows:
3. +/- key 68 changes sign of entries (in RPN). The E key 70 enters
exponents (e.g., 1.E-5).
4. % and .pi. keys 92 and 82 shifted give percent and pi.
5. Selected mathematical functions are:
trigonometric functions (sine, cosine, and tangent) and
inverses
inverse
exponentiation (Y.sup.x 10.sup.x, and e.sup.x)
square and square root
common and natural logarithms
6. X.rarw..fwdarw.Y key permits switch of X and Y values in the
display register.
7. Complex numbers and matrix mathematics can be performed with the
scroll keys 74 and 84 unshifted (.box-solid..tangle-solidup. and
.box-solid..tangle-soliddn.). This permits easy entry of matrix
data, inversion, determinate, transpose, and solution of
simultaneous equations.
Other functions can be added. Note that all the numerical keys have
no shifted functions, and are available for additional
functions.
Time and Medical Time Functions
As shown in FIG. 3, the TIME key 66 shifted
[.box-solid.x.rarw..fwdarw.y] obtains time functions for telling
time, alarms, timing, and time-stamping of data (as for patient
vital signs records). Selecting TIME brings the softkey
choices:
1. SET permits setting of the current date, time, and day of week.
(This function is shown on the screen 12 of FIG. 3). Pressing SET
brings a new set of softkeys:
12H on the softkey display 28 with softkey 40 selects 12 hour
display format, e.g. 11:00 pm instead of 23:00.
24H on the softkey display 30 with softkey 42 selects 24 hour
display format, e.g. 23:00 instead of 11:00 pm.
MDY on the softkey display 32 with softkey 44 selects
Month/Day/Year format for dates.
DMY on the softkey display 34 with softkey 46 selects
Day/Month/Year format for dates.
DAY on the softkey display 36 with softkey 48 selects day of week.
Pressing the DAY softkey 48 brings a new selection of softkeys as
shown in FIG. 4 with the days of the week. Softkeys 40, 42, 44, 46,
48, and 50 under MO, TU, WE, TH, FR and MORE in softkey displays
28, 30, 32, 34, 36, and 38, respectively. Selecting softkey 50
under MORE display SA, SU, and NONE (for no day display) in softkey
displays 28, 30, and 32 above softkeys 40, 42, and 44 (screen not
shown).
The scroll keys 74 and 84 unshifted (.tangle-solidup. and
.tangle-soliddn.) allow the user to move the cursor to the line
(time, date, day) for setting. Cursor position is indicated by the
.box-solid. in the current line. In an alternate embodiment, a
softkey could be added here for a flag to set visible or hidden
display of time on the top status line.
2. ALRM shown in FIG. 5 permits setting an alarm. There are two
softkey choices. (1) SET prompts for an integer (0-9, for up to 9
alarms). (2) CLR clears alarms that the user has set. After
entering the number, the SET display appears (similar to setting
time, except that there is the message SETTING ALARM N, as shown in
FIG. 5, and there are softkey choices--VIEW, LABEL, DAY and EXIT.
The DAY choices in this mode are expanded to include an additional
key for EVERY day, and a custom screen to select any combination of
days.
The LABEL softkey 42 permits entry of a line of alphanumeric
characters (up to 20) which is displayed when the alarm sounds.
After pressing the LABEL softkey 42, the user gets a prompt for a
label and a new set of softkeys for alphanumeric labeling as shown
in FIG. 6.
The .tangle-solidup..tangle-soliddn. symbols in the status line
display line 16 indicate the scroll keys 74 and 84 are active to
select a new row of softkeys for other characters, including
parentheses, and useful general and medical symbols. Number keys on
main keypad are used for numerical entry. The
.tangle-solidup..tangle-soliddn. keys 74 and 84 could also scroll
to pre-set messages for selection by the user, for example "CHECK
MEDS" or "CALL LAB".
Pressing EXIT key 104 sets the alarm and returns to main TIME
functions.
The status line on display line 16 shows that alarms are set when
the user is operating the device 10 in different modes.
3. TMR sets a timer as shown in FIG. 7. The user gets prompted for
H:M:S to set a timed interval. New softkey choices are BEG (to
start), STOP (to stop), and RESET keys.
4. STPW is a stopwatch as shown in FIG. 8 for timing events. The
displays are like the TM R function except the stopwatch counts up
(instead of down like the timer). There is also a SPLIT softkey 42
to record (and store in numbered sequence) split times. Using the
scroll keys 74 and 84 unshifted permits viewing the accumulated
split times.
Drug and Infusion Calculations
This mode, as shown in FIG. 9, permits calculation of patient doses
and infusion rates from the doctor's prescription orders. The
choice of any dimensional unit (ml, mcg, mg, etc.) can be selected
to simplify entry and avoid dimensional conversions. After
completing an entry, the setting can be stored (and labelled) for
future use.
Pressing DRUG key 42 unshifted brings a calculation screen which
shows all the variables needed. Orders (Rx), patient weight, drug
concentration, and calculated dose. The formula is:
DOSE=(Rx.multidot.WGT)/CONC
Two new softkeys also appear:
1. BSAIWGT--toggle softkey 48 for using Body Surface Area or Weight
for dosage calculation
2. RENAL--adjustments using softkey 50 for renal insufficiency.
The user can use the scroll keys 74 and 84 unshifted to select the
current line for data entry. The dimensional units of the current
line can be changed using the UNIT key 40 unshifted. Pressing UNIT
key 40 unshifted:
blanks all but the current line (except for scrolling values)
creates a scroll (in inverse color) in the units column of the
display with all the possible choices for units, e.g., mg, mcg, g,
etc.
creates one new softkey 50 shown in FIG. 10, SEL for selecting the
choice of unit.
The user uses the scroll keys 74 and 84 to scroll to find the
desired unit (only dimensional consistent choices are shown) and
presses SEL softkey 50 unshifted to return to the calculation
screen shown in FIG. 9.
If the user toggles to BSA (instead of WGT) using the softkey 46,
the user gets a screen for entering WGT and HGT (Height). BSA is
calculated from known nomograms. (See Cardiac function section for
formulae).
Infusion rate calculations are accessed by selecting INFUSE
(.box-solid. DRUG) key 42 shifted. The function is identical to
drug calculations except the order (Rx) has the units mass per
patient weight per unit time (e.g. mg/kg/min), and DOSE (shown in
FIG. 9, display line 24) has the units volume/time (e.g., ml/hr).
Select new units in the same manner as drug calculations.
While in the DRUG or INFUSE screen, the user can store the current
settings and recall the settings for future use (i.e. when using
the same medication on patients with different weights or
prescriptions). To Store the setting, press key 52 unshifted which
is STO N, where N is a number 0-9, for ten allowed drug or infusion
memory settings.
The user gets a prompt for a label and a new set of softkeys for
alphanumeric labeling as shown in FIG. 11. As an alternative, the
softkeys can be labeled with RX?, WGT, CONC, DOSE, etc. for direct
input. Touching one of the softkeys selects the associated input
and allows the input of data from the numerical keys. The cursor 24
will move to the appropriate location to indicate which associated
input is selected.
The .tangle-solidup..tangle-soliddn. symbols in the status line,
display line 16, indicate the scroll keys 74 and 84 are active to
select a new row of softkeys for other characters, including
parentheses, and useful general and medical symbols. Number keys on
the keypad are used for numerical entry.
The user can recall the settings from memory with the RCL DRUG N or
RCL INFUSE N command using RCL key 54 and DRUG or INFUSE key 42
unshifted or shifted, respectively. If the user has entered a label
for this setting, then the label will appear in the place of
softkeys 44 and 46 in the calculation display screen 12.
If the user gives no number choice for memory, i.e., RCL DRUG or
RCL INFUSE, then the screen displays a list of the labels of the
stored settings. The user can scroll and select choice.
The RENAL softkey 46 in FIG. 9 is an option that permits the user
to adjust the dose of common drugs for patients with renal
insufficiency. Pressing RENAL softkey 46 clears the DOSE/RATE
display and gives a screen 12 for creatine clearance CREA on
display line 22, the drug used on line 22, DRUG, and the fraction
for dose reduction on line 20.
Pressing DRUG key 42 in the RENAL screen allows the user to scroll
to choices of common drugs (a better entry system, such as letter
entry with word completion is another alternative as shown in FIG.
12). Selecting a drug returns to the display shown in FIG. 13 and
displays the fraction for reduction.
Values for dose correction are found in Clinical Nephrology 7:81
(1977). A partial list of drugs accessible on the screen 12 of FIG.
14 is:
______________________________________ Acyclovir Cephradine
Minocycline Amantadine Chloramphenicol Moxalactam Amikacin
Clindamycin Nafcillin Amoxicillin Cloxacillin Netilmicin
AmphotericinB Colistamethate Oxacillin Ampicillin Dicloxacillin
PenicillinG Azlocillin Doxycycline Piperacillin Bactrim/Septra
Erythromycin PolymixinB Carbenicillin Ethambutol Rifampin Cefaclor
Flucytosine Streptomycin Cefamandole Gentamicin Sulfisoxazole
Cefazolin Isoniazid Thiabendazole Cefoperazone Kanamycin
Ticarcillin Cefotaxime Ketoconazole Tobramycin Cefoxitin
Methicillin Trimethoprim Cephalexin Metronidazole Vancomycin
Cephalothin Mezlocillin Cephapirin Miconazole
______________________________________
Cardiac and Hemodynamic Function Calculations
This function, as shown in FIG. 15, permits calculation of the many
measures and indices that describe cardiac function. Many of the
measures use common input values--body surface area, measured
pressures, etc. Once entered, these values are shared among all the
measures that use them, so the user does not need to re-enter data
for different calculations. The CARD.heart. key 56 unshifted has
three sofikeys for evaluating the different cardiac functions, and
one key for reviewing (or inputting) patient data.
When the user selects a function or index to evaluate, the user
receives prompts for the necessary input data, and the function is
evaluated. The input parameters are stored for use in future
calculations because many cardiac functions have the same
parameters as independent variables. Thus, the user need not repeat
entries.
Values of cardiac function tests are found by scrolling through
lists of functions. Displayed values are divided into three groups
for easy access, in addition to patient data:
1. .heart.FNC--cardiac function tests starting with the screen 12
shown in FIG. 16. Values include:
CO, cardiac output (Fick or physiologic)
CI, cardiac index (CO/BSA)
SV, stroke volume (CO/HR)
SVI, stroke volume index (CI/BSA)
EF, ejection fraction (SV/EDV)
BVI, blood volume index
CBVI, central blood volume index
Calculation of cardiac index is shown on the screen 12 in FIG. 16
after softkey 46 has been pressed under CARD in the softkey display
34. In this case, the user must input the parameters which can
determine the cardiac output (CO), and the patient body surface
area (BSA). After pressing CO, the user gets a screen with these
two variables. Scrolling to the line, the user can either enter a
value directly, or select the parameter.
Selecting the parameter brings screen 12 of FIG. 17 to calculate
the parameter from other independent variables.
Selecting BSA prompts for patient height HGT and weight WGT. If not
entering CO directly, selecting CO gets a screen for determining CO
by the Fick Equation,
CO=V.sub.02 /8.5(CaO.sub.2 -CVO2), where
CaO2=1.36(Hgb)(SaO2)+0.003PaO2, and
CvO2=1.36(Hgb)(Sp vO2)+0.003PaO2.
The result of the above equations are displayed on the screen 12
shown in FIG. 18. Other methods of determining CO may be an option
for the CO screen. Again, once the basic parameters are entered,
they are saved for other functions.
2. WORK--cardiac work indices as displayed on the screen 12 shown
in FIG. 19.
LCWI, left cardiac work index
LCWI=CI.multidot.MAP.multidot.0.0136
LVSWI, left ventricular stroke work index
LVSWI=SI.multidot.(MAP-PAWP).multidot.0.0136
RCWI, right cardiac work index
RCWI=CI.multidot.MPAP.multidot.0.0136
RVSWI, right ventricular stroke work index
RVSWI=SI.multidot.MPAP.multidot.0.0136
3. RESIS--vascular resistances as displayed on the screen 12 shown
in FIG. 20.
SVR, systemic vascular resistance
SVR=(MAP-CVP).multidot.79.92/(CO)
SVRI, systemic vascular resistance index
SVRI=(MAP-CVP).multidot.79.92/(CI)
PVR, pulmonary vascular resistance
PVR=(MPAP-PAWP).multidot.79.92/(CO)
PVRI, pulmon. vascular resistance index
PVRI=(MPAP-PAWP).multidot.79.92/(CI)
The above vascular resistances are displayed on the screen 12 in
FIG. 20.
DATA--For data entry from DATA on the softkey display 32 and
softkey 44, the softkeys are:
a) PT--patient data. Pressing PT gives a new menu for HGT and WGT
as shown in FIG. 21. A display of BSA also appears. Initial value
of BSA is calculated using the algorithm:
BSA=(HGT).sup.0.425 .multidot.(WGT).sup.0.725
.multidot.0.007184
(BSA in m.sup.2, HGT in cm, WGT in kg).
BSA can be entered independently by scrolling to BSA and entering a
value. This value is retained for calculations. The Ideal Body
Weight estimates are here.
Pressing the UNIT key 40 unshifted allows the user to select new
dimensional units in the same manner as for the drug
calculations.
b) PRES--pressure data. PRESS gives six data lines of which four
are visible as shown in FIG. 22 for different pressures. The scroll
keys 74 snd 84 are used to select and enter data.
CVP, central venous pressure
SP, systolic pressure
DP, diastolic pressure
MAP, mean arterial pressure. If no value is given, the MAP value is
calculated from the SP and DP data by MAP=(SP+2 DP)/3, and marked
as estimate with *.
MPAP, mean pulmonary artery pressure
PAWP, pulmonary artery wedge pressure
Default units are mmHg, but the user can use the UNIT key 40
unshifted to select new units for each entry. Any calculations
using these values adjusts the units appropriately.
c) BLOOD--blood data. BLOOD gives six data lines of which four are
visible as shown in FIG. 23 for different blood parameters. The
scroll keys 74 and 84 are used to select and enter data.
SAO2, arterial oxygen saturation
SVO2, mixed venous oxygen saturation
HGB, blood hemoglobin
HCT, blood hematocrit
PVOL, blood plasma volume
PAO2, arterial O.sub.2 partial pressure
As always, the user can use the UNIT key 40 unshifted to select new
units for each entry. Any calculations using these values adjusts
the units appropriately.
d) HEART--heart data. HEART gives four data lines for heart
parameters as shown on screen 12 of FIG. 24. The scroll keys 74 and
84 are used and data entered.
CO, cardiac output. If CO is not entered, then, CO is calculated
using the Fick equation,
CO=VO2/8.5(CaO.sub.2 -CvO2), where
CaO2=1.36(Hgb)(SaO2)+0.003PaO2, and
CvO2=1.36(Hgb)(SvO2)+0.003PaO2.
MTT, mean transit time
EDV, end diastolic volume
ESV, end systolic volume
Use the UNIT key 40 unshifted to select new units for each entry.
Any calculations using these values adjusts the units
appropriately.
Respiratory and Ventilatory Calculations
These functions evaluate respiratory and ventilatory parameters as
shown on the device 10 in FIG. 25. In the same manner as for the
cardiac functions, the user can access a parameter to evaluate
(such as VC, vital capacity) and get a screen that prompts for the
needed variables. Once the variables are entered they are stored as
patient data and are used for other calculations.
The softkey displays 30, 32, and 34 with softkeys 42, 44, and 46
are respectively VENT for determining ventilation parameters, VOL
for finding vital capacity and noting the different lung volumes
(from pulmonary tests), and DATA for the patient data.
Descriptions of the function keys:
1. VENT softkey 46 in FIG. 25--ventilation parameters as shown on
screen 12 of FIG. 26. There are prompts for patient data, and
computation of minute ventilation (MV), tidal volume (TV), and
respiration rate (RESP) from the Radford nomogram. In this screen
the user can enter the inspired:expired ratio (I:E) and calculate
the required flow rate.
Scrolling to a variable and choosing SEL sofikey 48 gives data
screens (same as pressing the DATA key) as shown of screen 12 of
FIG. 27. The first screen is for HGT, WGT, and SEX (key prompts for
MIF). A display of BSA also appears. Initial value of BSA is
calculated using the algorithm:
BSA=(HGT).sup.0.425 .times.(WGT).sup.0.725 .times.0.007184
(BSA in m.sup.2, HGT in cm, WGT in kg).
BSA can be entered independently by scrolling to BSA and entering a
value. This value is retained for calculations. The user can scroll
to estimates of Ideal Body Weight (IBW).
Pressing the UNIT key 40 unshifted allows the user to select new
dimensional units in the same manner as for the drug
calculations.
The softkey 50 for MORE allows entry of other optional data as
shown on screen 12 in FIG. 28:
FEVT--fever temperature
ALT--altitude
INTB--intubation flag (Y/N)
DSPC--dead space
COMA--coma flag (Y/N)
AGE--age of patient
These data are used to correct the predicted tidal volumes, if
desired.
The useful formulae are:
MV (1pm)=BSA (m.sup.2).times.F.sub.sex
where F.sub.sex =4.0 (men), 3.5 (women)
TV (ml)=IBW (kg).times.2 (ml/kg)
where IBW is ideal body weight,
IBW.sub.men (kg)=HGT.sup.2 (m).times.23
IBW.sub.women (kg)=HGT.sup.2 (m).times.21.5
There are corrections for tidal volume:
a) not in coma, add 10%
b) Fever: add 9% every degree above 37.degree. C. (rectal)
c) Altitude: add 5% each 2000 ft above sea level (or 8% every 1000
m)
d) Intubation: subtract volume equal to weight in kg (1/2 weight in
lbs)
e) Dead Space: add equipment dead space.
2. VOL softkey 48 in FIG. 25--volumes. The first screen 12 in FIG.
29 is a display showing the relationship of lung volumes. There is
a softkey for calculating vital capacity, VC by the following
formulae (VC in ml, age in years, height in cm):
VC.sub.women =(27.63)-(0.112.multidot.AGE)).multidot.HGT
VC.sub.men =(21.78)-(0.101.multidot.AGE).multidot.HGT
The user can scroll to the different lung volumes on the screen 12
in FIG. 29 and enter values, from which others are calculated
according to the relationships shown on the VOL screen. Any known
value is shown in inverse in the softkey display 26.
3. DATA softkey 44 in FIG. 25--for patient data. The screens are
the same as those shown for data entry in the VENT functions. Data
can be entered here, in DATA mode, or in the function screens (VENT
and VOL). All data are retained for other calculations that require
them. If not erased, the data are also available to other
functions, such as the CARD functions, which use common variables,
such as patient height or weight.
Acid-Base Calculations
The acid-base functions shown for the device 10 in FIG. 30 (1)
permit calculations with all the usual acid-base equations
(Henderson-Hasselbach, Kassirer-Bleich, etc),(2) show a list of A-B
disorders and expected compensations, and (3) permit calculation of
the usual deficits and osmolality, etc.
The corresponding softkey displays 32, 34, and 36 for softkeys 44,
46, and 48 are respectively AB-EQ, DIS, and IONS.
1. AB-EQ--Acid-Base basic equations.
The choices, as shown in the screen 12 of FIG. 31, are for (1) the
Henderson-Has-selbach equation, (2) the Kaiser-Bleich equation, (3)
relation of pH and H+, and (4) arterial blood gas functions.
As always, independent variables are saved after they are entered
for use in other calculations.
For the Henderson-Hasselbach equations, which use the following
formulas, the data is prompted by the screen 12 in FIG. 32:
##EQU1##
The user can toggle between the H2CO3 or the PACO2 formulations
with the softkey, to accept either type of input.
The screen 12 in FIG. 33 for the Kassirer-Bleich equation is
similar to the H-H equation screen, except that the three variables
are H.sup.+, PCO.sub.2, and HCO.sub.3.sup.-. The formula is:
The relation between H.sup.+ and pH is found the next screen
choice. The user can scroll between the pH values and view the
H.sup.+. There is a key for temperature correction here. Selecting
TEMP allows entering a temperature and automatically corrects the
pH value (default is 37.degree. C.). (For the pH vs. H+ calculation
the "0.8/1.25" rule is used. This has the formula (H+ in
nEq/L):
The last AB-EQ function, as shown on the screen 12 in FIG. 34,
gives the corrections for arterial blood gases as a function of
temperature. If the temperature has already been entered it is used
here and need not be entered. The user can toggle between the
measured values or the correction factors. Uncorrected and
corrected values are differentiated by a *. The USE? softkey 44
asks to apply (use) or un-apply the correction factors to entered
ABG data. Approximate correction equations are found in J Am Coll
Emerg Physicians 8:247 (1979).
2. Acid-Base Disorders, DIS, as shown on screen 12 in FIG. 35. This
menu identifies simple acid-base disorders and indicates initial
changes and expected compensation. The six states (other than
normal) are:
metabolic acidosis
metabolic alkalosis
respiratory acidosis, acute
respiratory acidosis, chronic
respiratory alkalosis, acute
respiratory alkalosis, chronic
The screen 12 in FIG. 35 has two softkey display choices, SHOW or
FIND.
Scrolling to the selected disorder and choosing the SHOW softkey 48
gives principal facts about the disorder on the screen 12 in FIG.
36. The second screen shown in FIG. 37 is accessed by pressing the
NEXT softkey 50. The BACK softkey 48 under the softkey display 26
in FIG. 37 returns to the first screen of FIG. 36.
Selecting the FIND softkey 50 under the softkey display 26 in FIG.
35 prompts for ABG values pH or H.sup.+, and PCO.sub.2, or
HCO.sub.3- from the DIG screen. From the proper set independent
values, the device 10 identifies the acid-base state of the patient
according to the well-know relations shown in FIG. 38 (JAMA, 223:3
1973). This acid-base mapping shown in FIG. 38 could also be
displayed on a high resolution screen 12. Actual values can be
found using the screen 12 in FIG. 39.
Choosing RX? softkey 48 under the softkey display 36 offers the
clinician a recommended prescription, such as giving a suggested
amount of bicarbonate, or adjusting PCO.sub.2.
Thus by inputting a diagnosis, the device 10 outpus a recommended
treatment or course of action.
3. IONS as shown in screen 12 of FIG. 40--simple formulae for
calculation of other acid-base related quantities. There are five
choices:
AG: anion gap (in mEq/L):
AG=Na.sup.+ -Cl.sup.- +HCO.sub.3.sup.-
HCO.sub.3-, Deficit (in mEq/L):
HCO.sub.3.sup.-,def=[WGT].multidot.0.4.multidot.(des, HCO.sub.3
-meas, HCO.sub.3.sup.-)
BE, base excess (in mEq/L):
BE=(1-0.014Hgb).times.[(HCO.sub.3.sup.-
-24)+(9.5+1.63Hgb)(pH-7.4)]
OSM,S, serum osmolality (mOsmol/kg) where Na.sup.+ and K.sup.+ are
in mEq/L, Glucose and Urea in mg/dL. ##EQU2## XL, Lactate, excess
(mmol/L) ##EQU3##
Choosing these functions from the screen gives a screen 12 in FIG.
40 that prompts for the given independent variables, as shown in
the equations. As always, the user can select choice of units.
Also, if these values have been entered previously, they will
appear in the displays as defaults.
Nutritional Functions
The NUTR functions as shown in the computer 10 of FIG. 41 evaluate
nutritional status, metabolic functions, calculations for
hyperalimentation, and some special functions.
1. META softkey display 36 selection gives choice of
calculating:
BMR, basal metabolic rate (kcal/m.sup.2 /hr)
BMR=37-[AGE(yrs)-20]/10
BEE, basal energy expenditure (Harris-Benedict equations, in
kcal/hr)
BEE.sub.Male =66+13.7WGT+5Hgt-6.8Age
BEE.sub.Female =655+9.6Wgt+1.8Hgt-4.7Age
where for the BEE equations, Wgt is weight in Kg, Hgt is height in
cm, Age in years.
The screens and prompts are similar to screens shown earlier with
lines for the independent variables and the function result.
2. STAT softkey display 34 selection gives nutritional status
(assessment). Choices include:
NB, nitrogen balance (g) ##EQU4## BUN/Urea conversion BUN=Urea
/2.14
LBM, lean body mass (kg)
LBM=7.138+0.02908(Cr).sub.mgUrine, 24 hr
IBW, ideal body weight (kg)
IBW.sub.male =[Hgt(m)].sup.2 .multidot.23
IBW.sub.Female =[Hgt(m)].sup.2 .multidot.21.5
3. ALIM softkey display 32--for hyperalimentation. In these
calculations, the user determines the caloric and nutrient intake,
and fluid requirements of a patient. (This may depend on the
diagnosis and patient condition). Then, the user determines the
time, concentrations, and flow rate for the nutrients. The
calculations are a combination of caloric and fluid calculations,
and infusion calculations already mentioned. This function is very
useful.
Patient Logging and Key
These functions are shown on the computer 10 in FIG. 42. The PT key
110 unshifted allows the user to start a log of vital signs data
for a patient. Pressing PT key 110 gets the screen 12 where the
user can (1) enter a new patient name, or (2) scroll through a list
of existing patient files and select an existing patient.
If NEW softkey 46 is selected, then the user gets the usual
labeling screen with prompt for alphanumeric input, then a data
input screen. Choosing an existing name gets the data input screen
directly. The data screen 12 shown in FIG. 43 allows the logging of
four vital signs:
HR, heart rate
MAP, mean arterial blood pressure
RR, respiratory rate
TEMP. temperature
Current time is shown in the softkey line. Pressing STO key 52
saves the data and logs the current time. The user can scroll
through earlier entries with the scroll keys.
The key 110 shifted permits the user to store telephone data in an
alphabetized directory. Pressing key 110 gives a phone list, and
the option to enter new numbers in the standard manner.
Alphabetization is automatic.
Tables Of Normal Values And Common Nomograms
The NORM key 108 shifted, shown on the device 10 in FIG. 44,
accesses a vast amount data of "normal values". These data are
divided by function and include normal values for:
1. Blood chemistry (chemical)
2. Hematology (with age functions, lists of "Cytes", bone marrow
data, and chemical data)
3. Urine and urinalysis
4. Stool
5. Cerebrospinal fluid
6. Pleural fluid
7. Ascitic fluid
8. Gastric fluid
9. Synovial fluid
10. Semem analysis
11. Other miscellaneous (breath, sweat, etc.)
12. Cardiac function test results
13. ECG wave amplitudes
14. Echocardiography data
15. Pulmonary function test data (lung volumes, ventilation,
hemodynamics, gases, breathing mechanics)
16. Renal function
17. Endocrine function and hormones
18. Normal solutions and salts.
The user gets a scroll screen of these topics. After selecting a
topic, the user can scroll through values.
A typical source of such values are pocket-size handbooks, such as
Medi-Data's Normal Values, published by the Rodram Corp 1988,
Mexico City, or Facts and Formulas, compiled by R. C. Rollings,
M.D. 1985, publ. by McNaughton and Gunn.
Selecting NOMO key 106 shifted gives a scrolling menu of common
useful nomograms, formulae, and data including:
toxicity (e.g., acetaminophen and salicylate poisoning)
burn fluid replacement
gas bottle info (capacities, duration, and factors)
neutral thermal environment temperature, T=f(weight, age)
fetal age estimation (e.g., from OB ultrasound measurements)
Modes
Pressing the MODES key 68 shifted[.box-solid. (+/-)], on the device
10 shown in FIG. 45, brings up the softkeys selection in the
softkey displays 28, 30, 36, and 38.
Choices are:
1. Degrees or radians for angular calculations.
2. Rectangular or polar coordinates. Selecting POLAR converts the
current X and Y values to polar coordinates [X register
R=.fwdarw.(x.sup.2 +y.sup.2).sup.1/2, and Y register
.theta.=atan(y/x)]. Selecting RECT coverts back to rectangular
coordinates by using the inverse formulas.
3. An indicator note appears in the top display line 16 of the
screen 12 to indicate current mode choice (if unconventional, e.g.,
RAD) so that the user will not be confused about the current
setting.
4. Scroll keys 74 and 84 could be used to select other modes, if
needed.
Displays
Selecting the DISP key 70 shifted [.box-solid. ] on the device 10
in FIG. 46 permits control of the display format on the screen.
The choices are:
1. FIX softkey 40 for fixed notation, e.g., FIX 3 ENTER gives
display 1.000, FIX 6 ENTER gives display 1.000000, etc. Softkey
display disappears from screen after selecting ENTER.
2. SCI softkey 42 for scientific notation, e.g., SCI 3 ENTER gives
display 1,000E-3, FIX 6 ENTER gives display 1.000000E-3, etc. Soft
function line (bottom display line) disappears from screen after
selecting ENTER.
3. RDX. softkey 48 selects period (.) for decimal radix and comma
(,) for thousands delineation, e.g., 1,000.000.
4. RDX' softkey 50 selects comma (,) for decimal radix and period
(.) for thousands delineation, e.g., 1.000,000 (as in European
countries).
Other choices are possible by replacing the two unused softkeys
(between FIX/SCI and RDX choices) with scroll keys.
Clear
The CLEAR key 72 shifted in the device 10 shown in FIG. 47 permits
clearing of selected parts of the screen 12.
Use of the unshifted arrow [.rarw.] erases the last digit on the
current entry, e.g. 3.1418, gives 3.141. The user can repeat the
.rarw. key to continue erases (backspacing) over single digits
until the entire line is erased.
Use of the CLEAR key 72 shifted [.box-solid..rarw.] obtains a menu
of other erasing modes. The respective softkey 28, 30, 32, 34, and
38 selections are:
1. LINE which erases the entire current line, e.g., the X value (in
math mode) or the current function line (when in one of the
function modes, such as DRUG).
2. SCRN which erases the values from the entire screen. In a
function mode, the function remains on the screen, and only the
values are erased, leaving the screen ready for a new entry.
3. MEM which clears the values stored in the memory stack (from the
STO command for single values).
4. PTDAT which clears all data values currently in the data
calculation memories (weight, pressures, etc.).
5. MORE which obtains a new set of softkeys to clear other stored
items. The new softkeys are:
a. DRUG--which then brings a list of the stored DRUG programs onto
the screen, and a new CLR softkey. Use the scroll keys to select
the drug program to clear, then press CLR. If the user has labeled
the programs the labels appear in the list to make the selection
easier.
b. INFUS--same manner as DRUG above, but for infusion programs.
c. PT--same manner as DRUG above, but for records of vital signs
for patients. When PT is pressed, a labelled list of current
patients appears for selection.
The functions under the MORE softkey 50 could also have a print
function if the user has a printer.
While the invention has been described in conjunction with a
specific best mode, it is to be understood that many alternatives,
modifications, and variations will be apparent to those skilled in
the art in light of the aforegoing description. There are many ways
of implementing the present invention electronically based on the
above description as would be evident to those skilled in the art.
Different types of microprocessors, embedded processors, and
application specific integrated circuits could be used with
associated memory to implement the above invention. Accordingly, it
is intended to embrace all such alternatives, modifications, and
variations which fall within the spirit and scope of the included
claims. All matters set forth herein or shown in the accompanying
drawings are to be interpreted in an illustrative and non-limiting
sense.
* * * * *